Arthroscopes and other like optical instruments, such as endoscopes, have long been known in the field of surgery and in other fields. In this specification and in the appended claims the term "arthroscope" means and should be interpreted to include an endoscope or any other like optical instrument, whether used for surgery or otherwise. In this application, the invention is described in connection with an instrument employed for surgery, as in human surgery.
Over the last fifteen or more years the nature of surgery has changed substantially, with minimally invasive surgery becoming a mainstay. Within the orthopedic community, in particular, arthroscopy and similar techniques have become the most common surgical procedures. Surgery using such techniques is less painful for the patient and, in most instances, can be performed more quickly and safely than with techniques that require greater invasion of the patient's body; anesthesia is also less complicated, the surgery can often be handled on an outpatient basis, and the procedures are better from the standpoint of cost effectiveness. Patients return to normal life more quickly, and hospital stays may be reduced in length or even eliminated. However, all of these benefits are available only if the minimally invasive surgery allows for better diagnostic capabilities, improved surgical techniques, and reduced iatrogenic damage. Similar benefits are available with other, non-surgical, instruments.
One problem in these minimally invasive techniques derives from limitations in the arthroscopes, endoscopes and other principal optical instruments employed. In particular, the rather limited field of view afforded by even the best instruments commercially available in 1998 has inhibited progress to at least some extent; available instruments and techniques have not changed dramatically since 1985. A substantial improvement in the field of view available to a person employing an arthroscope or like instrument for exploratory or repair procedures is much needed.
Several techniques for modification (widening) of the view offered by arthroscopic/endoscopic instruments have been proposed, but they have not been especially successful. Generally, such proposals have required packing a plurality of movable lenses or prisms into the input end of the instrument; the resulting problems of precision of construction, precision of relative movements, space requirements, optical distortions, and elimination of undesired "ambient" light have been substantial. This is not particularly surprising; interaction between the prisms and lenses involved, along with light loss, exacerbates the problem.